Bashar Assad is not only the very model of an idiosyncratic species of modern leader but also personifies the peculiar phenomenon of the despotic doctor. There are many fascinating things about the blossoming in the 21st century of the gangster dictatorships of the Assad family in Syria or the Kims of North Korea who have transformed themselves, under the guise of socialistic-nationalist regimes, into new hereditary monarchies with the dark glasses and family feuds of a Mafia crew. In a wide variety of countries from Cuba and Congo to Azerbaijan, Togo and Equatorial Guinea, the hereditary principle is thriving in states that have become 21st-century monarchies in the age of internet and 24-hour news when royalty is out of fashion. Perhaps it just shows the strength of the hereditary principle, for even in democracies the attraction of familiar families is powerful: in India, Pakistan, the Philippines, South Korea and Indonesia, dynasties dominate democracy. Even in the US, Bushes and Kennedys retain plebiscitory allure.

The Assad family is a fascinating and blood-spattered soap opera that combines the brutal killings of a medieval court with the merciless sectarian hatreds of their Middle Eastern neighbourhood, the glamour of haute couture wives, the intimate fraternal rivalries of the Godfather and Sopranos and the banal affability of Instagram and Facebook.

Here is a family regime where Hafez Assad faced not only the rebellion of the Muslim Brotherhood but an attempted coup from his own brother Rifaat while the heir, Bashar’s brother Mahar, shot his brother-in-law and security boss in the stomach — just as in the similar Hussein family in Iraq, Saddam’s son Uday killed both his disloyal brothers-in-law in a shootout that belonged in Scarface, not Baghdad.

But here’s something else interesting too: Bashar Assad was trained as an eye doctor. He chose to specialise in the eyes because this involved less contact with blood. It is said that his father, Hafez, chose the shy, gentle Bashar to be a doctor since the eldest son, the swaggering, aggressive Basil, was clearly the heir apparent while the younger brother Mahar was a terrifying loose cannon. But when Basil was killed in a crash, it was the quiet ophthalmologist who was called to the throne.

The doctor swears by the Hippocratic Oath to treasure and respect human life and to save it wherever possible. Yet Bashar Assad has become a murderous despot who was trained as a doctor — what I call a doctator, a silly wordplay with an intriguing thought behind it, because Bashar is just the latest in a long line of murderous political doctors.

As a doctor’s son myself from a family full of medics, I’ve always been intrigued by this: many of the political doctors have used medical metaphors — the cutting-out of cancers — to justify their repression.

I wonder if instead of making flint-hearted murder harder, a medical training actually makes it easier? If the society is a body politic, isn’t a doctor perfectly qualified to purge it of the germ of opposition, cleanse it of the bacterium of treason, use the scalpel of power to cut out the tumours? Isn’t the scalpel a finer instrument than the sword, the mace, the machine gun?

Even more striking are the terrorist bosses who are also trained doctors — their case is stranger still, for while doctators can pose as statesmen far from the fray, the doc-terrorists are intimately involved in the killing of innocent women and children.

The first doctator was actually an American adventurer, William Walker, who trained and practised as a doctor before launching a series of extraordinary expeditions that culminated in his becoming the homicidal president and generalissimo of Nicaragua in 1856. He didn’t last long — being executed in 1860 aged only 36.

The supremo of African doctators was Dr Félix Houphouët-Boigny, the Francophile despot of Ivory Coast whose extraordinary career began as a doctor, included serving as minister of state in various French cabinets during the Fifties and then being Ivorian president for another 30 years: his moment of Ozymandian hubris was the building of a Catholic cathedral in the middle of the Ivorian jungle that actually is bigger than St Peter’s in Rome.

His contemporary, Dr Hastings Banda, who ruled Malawi in a reign of terror for almost 40 years, trained as a doctor in Tennessee and then at Edinburgh University in 1941, before practising in northern England and then London: his practice specialised in the venereal diseases of soldiers and sailors during the war. Perhaps this inspired his brutal treatment of opposition members who were fed to the crocodiles, and his prudish moral laws that banned miniskirts, boots and blouses for women.

The Old Lion began to lose his grip in the Nineties, and when he died he may have been over 100 years old.

The third of this troika of doc-tators of the late 20th century was Dr François Duvalier, who turned Haiti into a hellish torture chamber but always used his medical qualification and the terminology of disease to win trust and justify his repression: calling himself Papa Doc, a nickname designed to project paternal dependability, he won popularity with a medical campaign against tropical diseases. Elected president in 1957, he consolidated power using his gruesomely flamboyant Tonton Macoutes militia, combining the cosy prestige of a comforting family doctor with the fatal power of Baron Samedi, the Voodoo spirit figure associated with death and the holy grace of Jesus Christ. The Tonton Macoutes brazenly murdered at least 30,000 people before he handed over power to his son, Baby Doc Duvalier, who soon lost power.

In recent times, the Bosnian Serb leader on trial for crimes against humanity in the ethnic cleansing and mass killings of the Balkan wars, Dr Radovan Karadzic, henchman of President Milosevic, qualified as a doctor and psychiatrist. Before entering politics he was famously the team doctor for the Serbian soccer team.

Many of the most prominent terrorist leaders trained as doctors: Dr Ayman al-Zawahiri, the henchman of Osama bin Laden and mastermind of 9/11, now al Qaeda’s formal leader, was a doctor and surgeon who practised at Egyptian army clinics, at a hospital in Jeddah, Saudi Arabia, and later with the Red Crescent in Pakistan. At times he served as bin Laden’s physician.

Terrorists such as Dr George Habash, the Palestinian leader of PFLP in the Seventies, and Dr Abdel Rantisi, the Hamas leader behind the suicide bombings of Israeli civilians in the Nineties, were both trained and practising doctors who devoted themselves to the disassembling of innocent and random human bodies instead of their healing. Of course, in the developing world in the early-mid 20th century it was no coincidence that talented and ambitious young men became doctors, a prestigious profession of the middle class — it was not a vocation but simply a step on the educational road to power.

But it is striking in the case of Bashar Assad how often he uses the language of medical healing and cleansing in his political discourse. “A nation’s ills,” Dr Duvalier used to say, “demand a doctor” while Assad regularly talks of the bacterium of Muslim fundamentalism. I wonder if he understands the paradox of his life in the way Duvalier did: “A doctor,” said Papa Doc, “must sometimes take a life to save it.” Of course there are cases where the doctor himself is the disease.